Provider Demographics
NPI:1255058749
Name:FOUNDATIONS HEALTH & PHYSICAL MEDICINE
Entity type:Organization
Organization Name:FOUNDATIONS HEALTH & PHYSICAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ZEVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:906-563-5800
Mailing Address - Street 1:415 W US HIGHWAY 2
Mailing Address - Street 2:
Mailing Address - City:NORWAY
Mailing Address - State:MI
Mailing Address - Zip Code:49870-1175
Mailing Address - Country:US
Mailing Address - Phone:906-563-5800
Mailing Address - Fax:906-563-5809
Practice Address - Street 1:415 W US HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:MI
Practice Address - Zip Code:49870-1175
Practice Address - Country:US
Practice Address - Phone:906-563-5800
Practice Address - Fax:906-563-5809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty